V08-11 SINGLE PORT SIMPLE PROSTATECTOMY

Abstract

You have accessJournal of UrologyNOTES/LESS (V08)1 Sep 2021V08-11 SINGLE PORT SIMPLE PROSTATECTOMY Susan Talamini, and Simone Crivellaro Susan TalaminiSusan Talamini More articles by this author , and Simone CrivellaroSimone Crivellaro More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002041.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The open simple prostatectomy has been utilized in the surgical management of benign prostatic hyperplasia (BPH) in exceedingly large glands. More recently, laparoscopic and robotic approaches have been adapted. We aim to present our approach to the transvesical robotic assisted simple prostatectomy (RASP) utilizing the daVinci Single Port robotic platform. METHODS: Our patient is an 85yo male with a long history of urinary retention, and was catheter dependent. He failed medicotherapy and was interested in definitive surgical management. The transvesical approach was facilitated using cystoscopic guidance with CO2 insufflation. A suprapubic incision, three finger breadths above the pubic bone was carried down until the bladder was encountered, and a mucosal diverticulum was created. The light from the cystoscope guides dissection. The gland was enucleated in an avascular plane, and the prostatic fossa, urethra, and bladder neck are reapproximated. RESULTS: Our experience with the first 16 cases performed at our institution reveals a significant decrease in mean postoperative IPSS (25.5 vs 6.4, p-value<0.01), post void residual(PVR) (200 vs 44.6, p-value 0.048), PSA (11 vs 0.6, p-value 0.5), and no patients developed stress urinary incontinence. One patient developed de novo urge urinary incontinence. The patient highlighted in this video was discharged on postoperative day(POD) 0, his catheter removed POD 5, and his PVR was 45ml on follow up. CONCLUSIONS: The Single Port RASP is an innovative approach to the treatment of BPH. We have found excellent functional outcomes postoperatively, with significant decrease in PVRs, and no patients developing stress urinary incontinence postoperatively, potentially owing to the minimal traction on the rhabdosphincter, judicious use of energy application, and the bladder neck reconstruction. The Single Port RASP is a viable approach to the surgical management of large gland BPH. Source of Funding: No sources of funding to declare © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e604-e604 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Susan Talamini More articles by this author Simone Crivellaro More articles by this author Expand All Advertisement Loading ...